^99mTc-labelled heat-denatured erythrocyte SPET-CT matching to differentiate accessory spleen from tumour recurrence

Excerpt

Selective spleen imaging using technetium-99m labelled heat-denatured autologous red blood cells has been used for various clinical applications [1]. Recently we utilised this technique in a 61-year-old patient with a history of left nephrectomy, due to a renal cell carcinoma, followed by postoperative intra-abdominal abscess leading to drainage and splenectomy. Two years after surgery, a CT of the abdomen (A) demonstrated a solid mass in the left renal space suspected to represent tumour recurrence (arrow). In order to exclude ectopic spleen tissue in this area, scintigraphy using ^99mTc-labelled heat-denatured erythrocytes was performed. Planar images (B) showed focal uptake in the left upper abdomen suggestive of accessory spleen. After matching of SPET (C) with CT, the area of intense ^99mTc-labelled heat-denatured erythrocyte uptake was seen at the location of the solid mass in the left renal space (D). Ectopic splenic tissue simulating abdominal tumours may be observed in cancer patients and the use of SPET with ^99mTc-labelled heat-denatured red blood cells combined with CT can be helpful to elucidate this clinical dilemma. …